Twin toddlers El and Ally recently achieved a major milestone after undergoing successful separation surgery at Seattle Children’s Hospital, concluding a journey that began when their mother discovered during pregnancy that her daughters were conjoined at the pelvis.
Sam Albalushi initially celebrated learning she was expecting twins, but third-trimester complications emerged when scans revealed the babies weren’t moving in utero. The full extent of the situation only became clear at delivery.
“All the doctors, they ran to a corner, and everyone was so shocked in that room,” Albalushi recalled. Medical staff immediately transported the newborns before she could see them, leaving her in shock about her daughters’ condition.
The twins were attached at the pelvis, presenting complex medical challenges that would require specialized care. After the initial adjustment period, Albalushi embraced her daughters’ condition while researching separation possibilities.
“I’ve never seen conjoined twins before, but they were looking so beautiful, so incredible,” she said of her first NICU visit. “I started crying, and I was so happy.”
However, practical and medical considerations motivated the family to pursue separation. Daily activities proved challenging, and the twins’ shared anatomy meant if one required hospitalization, both were affected. Sleep patterns were disrupted when one twin remained awake, and mobility limitations would intensify as they aged.
The family relocated from the Middle East to Seattle specifically for medical care. “I just took my laptop, and I started looking for all the hospitals, articles, and research papers,” Albalushi explained regarding her global search for qualified surgeons.
Dr. Caitlin A. Smith, co-director of the Reconstructive Pelvic Medicine Program at Seattle Children’s, assembled a 30-person surgical team including urologists, gynecologists, plastic surgeons, and neurosurgeons. The primary concern involved ensuring each twin had functioning bladder, bowel, and gynecologic systems that could operate independently.
“A lot of conjoined twins have organs or blood supply that cannot be separated safely,” Smith explained. “We needed to establish that their pelvic organs could be separated safely.”
The team conducted six months of planning sessions and practice runs before performing the 18-hour separation surgery when the twins were 15 months old.
Physical therapists Sarah Lewis and Maya King now work with El and Ally on developing independent mobility skills. “Since we’ve seen them, they’ve been able to pull themselves up into standing positions and work on standing for the first time,” Lewis noted.
Beyond physical rehabilitation, the twins face emotional adjustment to their new independence. “They were smiling and they were also confused, like ‘What’s going on and why is she in another crib?'” Albalushi observed post-surgery.
The separation allows Albalushi to experience typical maternal bonding she missed initially. “I’m hugging them, and I’m kissing them every time,” she said, describing newfound opportunities for individual cuddles.
Despite successful separation, extensive follow-up care continues including appointments with kidney specialists, urologists, plastic surgeons, and developmental doctors, plus ongoing speech, feeding, and physical therapy sessions.
The family established a GoFundMe campaign to assist with ongoing medical expenses as El and Ally continue their recovery journey.
